IMF RAW Run Leader Personal Information Form

IMF RAW RUN LEADERS

Personal Information

All IMF RAW Run Leaders must complete the Run Leader Personal Information form, which acknowledges and accepts the terms of the IMF RAW Code of Conduct.

"*" indicates required fields

RAW Community*

Name*

Address*

State*

Email*

Phone Number*

Date of Birth*

Gender*

ABOUT YOU

I AM:*

My mob/tribe/country is:*

Shirt Size*

Shoe Size*

Medical Information

Do you have any physical, medical or intellectual impairment that may affect your ability to coach?*

If Yes, please list any current or pre-existing medical conditions you have.*

Do you have any current or pre-existing sports injuries?*

If Yes, please list any current/recurring injuries.*

Accreditation and Experience

What accreditation have you complete below?

Community Run Leader*

Level 1 - Date Completed

Level 2 - Date Completed

First Aid & CPR*

First Aid Expiry Date

CPR Expiry Date

Working with Vulnerable People / Children card*

If you hold a WWVP card in more than one state please list your home state here and add the additional details in the 'Other relevant experience' section below.

State Issued

Card Number

Expiry Date

Your current job role/position and professional background.*

Other relevant experience, qualifications and/or certificate relevant to health, fitness, education, and coaching.

Signature*

Date*

Phone

This field is for validation purposes and should be left unchanged.

IMF RAW RUN LEADERS

Personal Information

ABOUT YOU

Medical Information

Accreditation and Experience

Have A Question? CONTACT OUR TEAM.

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Email: kylie.y@imf.org.au

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